One neurosurgeon had over a dozen malpractice claims in two states, including accusations his surgeries left patients paralyzed or dead.

USA Today has done an excellent investigation into the Department of Veteran Affairs. Its latest bombshell shows that the VA has hired doctors they know have malpractice claims and felony convictions. How could this possibly happen? A not so thorough hiring process:

Applications are vetted, education and licenses verified, references checked, and interviews conducted. For clinical hires, a review and approval by a professional standards board also is required.

But when applicants disclose prior problems with medical licensing short of revocation, malpractice or criminal histories, VA hospital officials have discretion to weigh the providers’ explanations and approve their hiring anyway.

There’s another reason why those with shady pasts find the VA so welcoming:

Agency clinicians aren’t required to have malpractice insurance — the federal government pays out claims using taxpayer dollars — making the VA a good fit for providers who may have difficulties securing malpractice insurance in the private sector if past issues have rendered them too risky.

Yes, OUR tax money pays the claims for this horrible doctors who mistreat our veterans, the people who in this country deserve the absolute best care.

Neurosurgeon John Henry Schneider

Look at neurosurgeon John Henry Schneider. He applied for a job at the VA in Iowa City, IA, and told them up front that Montana and Wyoming revoked his medical license. Why did the state do that? USA Todayexplained:

Neurosurgeon John Henry Schneider racked up more than a dozen malpractice claims and settlements in two states, including cases alleging he made surgical mistakes that left patients maimed, paralyzed or dead.

He was accused of costing one patient bladder and bowel control after placing spinal screws incorrectly, he allegedly left another paralyzed from the waist down after placing a device improperly in his spinal canal. The state of Wyoming revoked his medical license after another surgical patient died.

Montana

Schneider’s troubles in Montana started almost right away after he began performing surgeries in 1997 when patient Jason Zimmerman’s family rushed him to the ER:

He had excess fluid building up around his brain that was creating dangerous intracranial pressure, according to court records. A tube and valve system that had been implanted to drain excess cerebrospinal fluid had malfunctioned.

His family sued Schneider and a practice partner alleging they provided substandard care and Zimmerman suffered “profound neurological injury” that left him permanently impaired, the complaint says.

He and his family members ultimately dropped their malpractice suit because they worried Zimmerman’s prior substance abuse would impede the case, his sister Wendy Conaway told USA TODAY. Schneider blamed his partner for the injuries.

He faced FOUR malpractice claims in FIVE years in Montana, including one from a wife whose husband died “from complications after four surgeries.”

Wyoming

So Schneider went to Wyoming. He even established Northern Rockies Insurance Company that provided him with malpractice insurance. To absolute no one’s shock, that move “eventually helped land him in bankruptcy and unable to pay off his claims.”

Between 3006 and 2012 he faced at least EIGHT malpractice claims. One patient died:

The case that captured the attention of Wyoming Board of Medicine officials was Russell Monaco, a father of two who went under Schneider’s knife in 2011 for a procedure to decrease pressure on nerves in his lower back, according to a wrongful death suit filed by his wife, Kathy.

After the operation, he was prescribed a litany of narcotics that can depress breathing, including fentanyl, oxycodone, valium, and Demerol. Monaco’s oxygen levels dropped dangerously low, but Schneider discharged him anyway, medical board records show.

He went home and took the medications as prescribed, the lawsuit says, but his family found him dead the next morning. The coroner determined the cause of death was “mixed drug overdose.”

“I tried to wake him up and yelled and the girls came down screaming,” his wife, Kathy Monaco, told USA TODAY. “It was horrible, I mean, I live that day over every day.”

USA Today easily found this information. Despite all of this information readily available, the VA hired him! Do you think Schneider changed his ways? Nope:

He started work in April at a hospital that serves 184,000 veterans in 50 counties in Iowa, Illinois and Missouri.

Some of his patients already have suffered complications. Schneider performed four brain surgeries in a span of four weeks on one 65-year-old veteran who died in August, according to interviews with Schneider and family members. He has performed three spine surgeries on a 77-year-old Army veteran since July — the last two to try and clean up a lumbar infection from the first, the patient said.

Authorities arrested Schneider in September “on federal criminal charges of lying and trying to conceal assets in his bankruptcy case in Montana.”

When he returned to Iowa, he told his bosses what happened and they allowed him to keep practicing!

Schneider’s Patients

USA Today spoke to a few of Schneider’s patients that had complications after their surgeries.

Schneider performed a surgery to retrieve a benign tumor in Richard Joseph Hopkins’ brain over this summer. But complications led to three more surgeries and Hopkins passed away from an infection.

James Wehmeyer had an operation on his spine over the the summer, but Schneider had to perform two more surgeries due to infections. He had his last surgery last month, but still has a gaping wound that a nurse has to clean out every three days.

USA Todayreported that “three other patients suffered infections after procedures Schneider conducted at the Iowa City VA – two deep-wound and one superficial – but they were cured with antibiotics.”

Other Horrible Hirings

A VA hospital in Muskogee, OK, hired a psychologist that received sanctions before for sleeping with a patient. The officials hired him anyway:

The VA hospital in Muskogee, Okla., hired a psychiatrist in 2013 with multiple disciplinary actions against his Oklahoma license, including for sexual misconduct, according to internal documents obtained by USA TODAY.

Hospital officials knew about his past, but approved his hiring anyway with the condition he be closely monitored during his probation period, the documents show.

And yet the psychiatrist, Stephen Lester Greer, went on to have a sexual relationship with a VA patient and ended up pleading guilty in August to witness tampering for trying to persuade the patient to lie about it to federal investigators.

The VA hired a psychologist to work at a clinic in Lafayette, La., in 2004, despite his revealing previous felony convictions on his application, according to the internal documents, which don’t identify the provider by name. The VA didn’t run a criminal background check until a year after he started work. It showed eight arrests, including for burglary, drug dealing and reckless driving resulting in death.

Still the VA allowed him to continue practicing until two years ago. By that time, the VA had received multiple complaints about patient mistreatment by the psychologist. An internal investigation found he was a “direct threat to others, (and) to the Department’s mission.” The VA fired him earlier this year.

1) The agency always attempts to reduce service costs as much as possible, except in the case of favored suppliers.

2) It cares nothing, as an entity, for the people that they service.

3) Bureau directors and managers firmly believe that the agency exists to benefit them and no one else.

Once people realize the almost universal mind-set existing in these agencies, especially at the federal level, then things like this are no surprise. It’s just another day in the land of government bureaucracy.

This past August I had surgery to remove a melanoma on my neck. At the same time my brother had surgery to remove a melanoma from his chest. One big difference, my tumor was diagnosed in mid-July, he pointed his out to his VA doctor in his annual check-up a year ago. They told him they wanted to ‘see what develops’. Sure enough, his growth grew so this year they did the biopsy and sure enough, it was cancer. Melanomas are nasty and can spread quickly, especially to other organs. My doctors jumped into action to took care of it; his VA doctors let his grow for another year before they even took a biopsy. People wonder why we hate the VA.

As a Vet, I can assure you that your brothers doc has an attitude prevalent in many VA clinics. From my experience, the deciding factor is the money spent rather than the proper procedures followed. This is translated as NEVER do today what you can do tomorrow – and who knows, maybe the patient will die first. Also, I’ve noticed that the general providers love to throw pills at problems rather than be proactive in treatment. There are anomalies to my statements, but the nastiness pops up in the weirdest places. The government union is a BIG problem in fixing the VA Medical Centers.

In short Yes they do. While of course you will make more in Private Practice the VA is very competitive, especially when you consider the federal benefits attached to the positions. But just like every federal agency they hire towards the lowest common denominator.

Many years ago I had a position that allowed me to see the medical records of many VA patients. During that time I developed the opinion that some brilliant physicians worked part time at the VA to develop new techniques and therapies while personally protected from malpractice risks. Strictly anecdotal and just my opinion, but I had residence to support it at the time. And there were several on the medical staff that just came across add incompetent.

Thinker,
I have been in medicine for over 40 years and never heard of doctors developing skills at the VA. If you had residences telling you this they were blowing smoke somewhere you might not like. Now, most private doctors avoid the VA as they know walking in the door will lead to a suit or a complaint from the nurses.

I will give one example. Vet was coming in around the 20th of each month complaining of severe headaches and was admitted and administered pain meds. On the 1st of the month he left the facility AMA. Recurring pattern over several years. Vet received a service connected disability check and was an alcoholic, checks came out on the first of the month. Part of his skull was removed to determine if the headaches were caused by increased intracranial pressure, he was given a helmet and told not to allow any impacts to his head.

As I said, this is the opinion I developed and I don’t know that is why incidents like these occurred, but I can’t think of a rational explanation for something like this to happen. It would seem to me the headaches were caused by no money around the 20th of the month. I freely admit my opinion could be wrong.

Thinker,
I have never heard of anything like what you described. It is easy to check intracranial pressure, you just look at the eye grounds, proven method for a few hundred years. Or you can do a spinal tap or obtain an MRI. To do surgery in the manner you described would be against the standard of care and the doctor could go to jail.

Except at the VA, perhaps. I was not a VA employee, I worked for a company with a VA contract over 30 years ago during the Carter era. When started seeing the VA whistleblowers come out, I just thought nothing has changed over the years.

Thinker,
Don’t get me wrong. The VA stinks from administration to nurses to doctors to the janitor. It is just that we need to point out how bad it is over and over again. To me, the best way of taking care of the situation would be to do away with the VA completely. The reason for it to begin with was the unique nature of war injuries and having people to take care of that. Those days are gone. Now, you can not beat private care medicine for trauma and the VA is way behind. The patients love the VA as they can go down and smoke and tell war stories (lies, as I have rarely seen a front line soldier in the VA). Take all the money going into the system and buy the best insurance policy for these guys.

I’m not sure it’s possible for a physician to develop anything new at a VA hospital. Sure, there are occasional clinical trials, but they tend to go on at many hospitals across the country at the same time.

Now, should an attending physician empower his or her residents to try out unproven or investigational procedures under his license, well, that is at the very least unethical. If he or she asks residents to help carry out an investigational procedure, that’s incredibly wrong, the attending or teaching physician has a duty to the patient and the house staff to provide evidence-based ‘standard of care’ treatment and not fool around with the taxpayers money or the patients life.

The VA is not known for innovation for a reason. Most of us physicians here avoid the facilities as the association is not good for a doctor’s professional reputation. I don’t buy it.

A little background on malpratice, almost all doctors get sued. If your doctor says he hasn’t been sued, then he is either lying or seeing about one person per day and has luck. The neurosurgeon you described has the smallest number of malpractice claims for a neurosurgeon that I have seen. I am a physician and I have had attempted legal action by people I had not seen or billed. I also do witness work on both sides and can assure you that malpractice is a joke.

As to the psych docs. They are nuts, that is why they go into that branch.